NCLEX-PN (Practical Nurse) Study Guide

Up to 5 hours (300 minutes), including all breaks and the tutorial.

It is a pass/fail exam — there is no numeric score reported.

$200 (USD), paid to Pearson VUE at registration.

Physiological needs first (airway, breathing, circulation), then safety, then psychosocial needs.

Airway, Breathing, Circulation — the order in which to assess and intervene in an emergency.

HR 60–100 bpm, RR 12–20/min, BP ~120/80 mmHg, temp ~98.6°F (37°C), SpO₂ ≥95%.

Stable, predictable patients with expected outcomes can go to the LPN; unstable, newly admitted, or acutely changing patients require the RN.

Right patient, drug, dose, route, time, and documentation (often expanded to include reason and response).

Don: gown, mask/respirator, goggles, gloves. Doff: gloves, goggles, gown, mask — remove the most contaminated items first.

Reposition to high-Fowler's (sitting upright) to maximize lung expansion, then assess and administer oxygen as ordered — airway/breathing come first.

Between 85 and 150 questions, delivered by computerized adaptive testing (CAT).

The LPN/LVN provides care under RN or physician supervision; the RN performs the initial assessment, care planning, and patient teaching. LPNs collect data and reinforce teaching but do not create the initial care plan.

To maintain cellular homeostasis by using ATP to actively transport 3 sodium ions out and 2 potassium ions in, maintaining the resting membrane potential necessary for nerve and muscle function.

Osmotic pressure is the force exerted by dissolved solutes that draws water across a semipermeable membrane. Clinically, it determines whether IV solutions are hypotonic, isotonic, or hypertonic, affecting fluid movement into/out of cells.

Muscle weakness, cardiac dysrhythmias (peaked T waves on ECG), paresthesias, anxiety, and abdominal cramping. Severe hyperkalemia can cause cardiac arrest.

Positive feedback amplifies a change and moves away from homeostasis (e.g., blood clotting cascade). Negative feedback counteracts a change and returns to homeostasis (e.g., thermoregulation). Negative feedback is more common in maintaining stability.

It is a thin, highly permeable barrier (about 0.5 micrometers) that allows rapid diffusion of oxygen into the blood and carbon dioxide out. Damage to this membrane (ARDS) impairs oxygenation.

Decreased renal perfusion stimulates renin release, which converts angiotensinogen to angiotensin I, then to angiotensin II. Angiotensin II causes vasoconstriction and stimulates aldosterone release, increasing sodium and water reabsorption, raising blood pressure.

Inflammatory phase (0-3 days): hemostasis, inflammation, removal of debris. Proliferative phase (3-21 days): angiogenesis, collagen deposition, epithelialization. Remodeling phase (weeks to years): collagen cross-linking, scar maturation.

Anaphylaxis is a severe, life-threatening IgE-mediated hypersensitivity reaction. Immediate actions: call for help, give IM epinephrine, establish IV access, lay client flat with legs elevated, give oxygen, monitor vital signs, prepare for airway management.

It increases heart rate and contractility, dilates bronchi, dilates pupils, decreases GI motility, increases blood glucose, and causes vasoconstriction. It prepares the body for immediate physical action in response to perceived threat.

Absolute contraindications mean the medication/treatment must never be used. Relative contraindications mean it can be used only with caution, close monitoring, or if benefits outweigh risks in specific clinical situations.

Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. Criteria include abnormal body temperature (greater than 38.3 C or less than 36 C), altered mental status, and tachycardia (greater than 90 bpm).

The glomerulus is a capillary network that filters small molecules (glucose, urea, water, ions) due to hydrostatic pressure. The Bowman capsule (bowman's capsule) surrounds the glomerulus and collects the filtrate, which then passes through the proximal convoluted tubule.

Surfactant reduces surface tension in the alveoli, preventing their collapse during expiration. This decreases the work of breathing and increases lung compliance. Premature infants lack adequate surfactant, leading to respiratory distress syndrome.

Cells develop insulin resistance, meaning they do not respond normally to insulin signaling. The pancreas initially compensates by producing more insulin, but eventually beta cell function declines. This results in hyperglycemia despite elevated insulin levels.

Confusion or altered mental status, dry mouth and mucous membranes, poor skin turgor (though less reliable in elderly due to elasticity loss), decreased urine output, orthostatic hypotension, and elevated BUN-to-creatinine ratio.

Phagocytosis is the process where neutrophils and macrophages engulf and destroy pathogens and debris. After engulfment, lysosomes fuse with the phagosome, releasing enzymes and reactive oxygen species that kill the pathogen. This is a key defense against bacterial and fungal infections.

The BBB is a highly selective semipermeable membrane that prevents most large molecules and hydrophilic drugs from entering the CNS. Only lipophilic, small molecules, or those with specific transport carriers can cross. This affects antibiotic and chemotherapy dosing for CNS infections.

The parasympathetic nervous system decreases heart rate and contractility (via the vagus nerve) and increases GI motility and secretions, promoting digestion. It is the dominant system during rest and recovery, opposing sympathetic effects.

Both signs suggest meningeal irritation. A positive Kernig sign is pain and resistance when extending the knee with the hip flexed. A positive Brudzinski sign is involuntary knee flexion when the neck is flexed. Both raise suspicion for meningitis and warrant further investigation.

At the neuromuscular junction, acetylcholine binds to nicotinic receptors on muscle, causing depolarization and muscle contraction. In parasympathetic transmission, acetylcholine binds to muscarinic receptors on target organs, producing parasympathomimetic effects (SLUDGE: salivation, lacrimation, urination, defecation, GI upset, emesis).

Blood consists of plasma (water, proteins, glucose, ions) and formed elements: red blood cells (oxygen transport), white blood cells (immunity), and platelets (hemostasis). The hematocrit is the percentage of RBCs by volume; normal is 38-50% in men and 35-45% in women.

The bicarbonate buffer system (H2CO3/HCO3-) is the primary extracellular buffer. CO2 combines with water to form carbonic acid, which dissociates into hydrogen and bicarbonate. The lungs regulate CO2 (respiratory compensation) and kidneys regulate HCO3- (metabolic compensation) to maintain pH 7.35-7.45.